Virtual Multidisciplinary Review of a Complex Case Using a Digital Clinical Decision Support Tool to Improve Workflow Efficiency

Khee Chee Soo,1 Issam Al Jajeh,2 Raymond Quah,3 Hoe Kuen Brandon Seah,4 Sharon Soon,4 Espen Walker4 1General Surgery Department, Farrer Park Hospital, Singapore; 2Department of Pathology, Farrer Park Hospital, Singapore; 3Department of Diagnostic Radiology, Farrer Park Hospital, Singapore; 4Roche Diagnostics Asia Pacific, Ltd, SingaporeCorrespondence: Espen WalkerRoche Diagnostics Asia Pacific, Ltd, 8 Kallang Avenue #10-01/09 Aperia Tower 1, 339509, SingaporeTel +65 8428 0386Email espen.walker@roche.comObjective: Integration of distinct clinical perspectives in multi-disciplinary tumor board meetings is critical to determine optimal patient care. Digital tools can support the data consolidation needed for meeting preparation and data sharing during complex case reviews. In this paper, we assessed the value of a clinical decision support tool on workflow efficiency and conducting a complex case review of a dermatofibrosarcoma protuberans (DFSP) tumor.Methods: Case presentation was performed by each unique clinical specialty that had relevant information about the patient; an oncologist, a pathologist, and a radiologist. Virtual discussion was completed online with case presentation and documentation with NAVIFY Tumor Board. Workflow efficiency assessment was done through interviews and observation of the # of steps across different team members involved in preparing and conducting cancer multidisciplinary team (MDT) meetings before and after the implementation of the NAVIFY Tumor Board solution.Results: Case review consisted of surgical and therapeutic intervention history, distinct histological and sequencing patterns representative of DFSP, with radiological review to determine areas for surgical intervention. Consolidation of clinical input led to a recommendation of a formal external hemipelvectomy with potential chemotherapy. Workflow assessment demonstrated a 46% total reduction in the # of steps for meeting preparation (from 69 to 37), with specific changes based on role: data manager (33 to 15), pathologist (26 to 13), radiologist (no change), and logistics (5 to 4). There was a 31% total reduction in the # of steps for conducting the meeting (from 51 to 35).Conclusion: Utilizing a digital clinical decision support tool helped to consolidate patient data and improved case presentation through workflow efficiency. This allowed for improved interdisciplinary discussion on a complex DFSP case and supported the determination of a clinical decision.Keywords: multidisciplinary team meetings, clinical decision support, digital tool, workflow efficiency, virtual MDT